The effect of Bosentan on healing of colonic anastomosis

BACKGROUND: Ischemia is the most important factor compromises wound healing in colonic anastomosis. Mesenteric vessels are ligated at first while performing colonic resection and following anastomosis. Therefore blood supply of the related segments of colon temporarily interrupted and ischemia can easily occur. This study was carried out to explore whether Bosentan, an endothelin-receptor antagonist, can eliminate vasoconstruction, increase blood flow in the splanchnic area and anastomotic region and therefore possibly facilitate wound healing and prevent intra-abdominal adhesion formation. METODS: Study is conducted on 30 female Wistar-Albino rats weighing 180–240 gr. Rats were allocated into three groups. Group 1 (n = 10) recevied full-thickness resection of the left colon and end-to-end anastomosis. In Groups 2 (n = 10) and 3 (n = 10), vessels of 2–3 cm segment of the left colon were ligated, indications of necrosis of that segment were expected, followed by resection and end-to-end anastomosis. Two milliliter of saline and 5 mg/kg Bosentan was given intraperitoneally in Group 2 and 3, respectively. On postoperativ day 6, intra-abdominal adhesions were scored. Healing of anastomosis, anastomotic bursting pressures, tissue hydroxyproline levels and histopatologically healing scores were assessed. RESULTS: Macroscopic adhesion score in Group 3 was lower than the remained groups (p < 0.05). Tissue hydroxyproline levels were significantly higher in Group 3 compared to the Groups 1 and 2 (p < 0.001). Mean anastomotic bursting pressures were 200 mmHg, 164 mmHg and 240 mmHg in Groups 1, 2 an 3, respectively (p < 0.05 between Groups 1 and 3; p < 0.001 between Groups 2 and 3). Histopathologically, healing scores of Group 1 were significantly higher than the other groups (p < 0.05 group 1–3, group 2–3). CONCLUSION: Bosentan increases anastomotic healing of ischemic colonic anastomosis and decreases intra-abdominal adhesion formation

A case of primary gastric choriocarcinoma and a review of the Turkish literature:An extremely rare carcinoma of the stomach

Primary choriocarcinoma of the stomach is an extremelyrare and highly malignant tumor. A 60 years old man visitedanother hospital for the chief complaint of the stomachacheand black stools. A large ulcero-vegetative tumoroccupying the gastric body and antrum was seen in theupper gastrointestinal endoscopy. It was diagnosed asgastric adenocarcinoma by endoscopic biopsy. The patientadmitted to our hospital for treatment. The patientwas assessed as a gastric adenocarcinoma complicatedwith hemorrhage. In the exploration, it was observed thatthe mass arising from gastric body was invaded the transversecolon and pancreas. The lymphadenopaties in theceliac axis were conglomerated and had invaded the celiacvessels. A subtotal gastrectomy and an extended righthemicolectomy were performed for palliation. In pathologicalfindings, typical characteristics of two cell pattern consistingof syncytiotrophoblasts and cytotrophoblasts wereobserved. The tumor consisted of only choriocarcinoma.For the definite diagnosis of choriocarcinoma, immunohistochemi-cal tests were performed. Beta-HCG andEMA staining were positive. The patient was invited forcontrol because of gastric choriocarcinoma three weekslater surgery. His serum beta-HCG level was 458 mIU/mL(normal range, <0.5 mIU/mL). For the differantiation fromthe primary choriocarcinoma in the testis or mediastinum,testicular ultrasonography and chest CT were performed.Abnormal findings were not detected in the tests, so itwas diagnosed as primary gastric choriocarcinoma. Thepatient refused chemotherapy. Three months later, hehad inguinal lymphadenopaties and multiple metastasesin lung. He died 5 months after surgery because of respiratoryfailure

The Effect of Antivascular Endothelial Growth Factor on the Development of Adhesion Formation in Laparotomized Rats: Experimental Study

Aims. This study determined the effects of a single dose of bevacizumab, an antiangiogenic recombinant monoclonal antibody that specifically targets vascular endothelial growth factor (VEGF), on adhesion formation in the rat cecal abrasion model. Methodology. Thirty female Wistar albino rats (200–224 g) were divided into three groups. All rats underwent laparotomy at which time cecal wall abrasion and abdominal wall injuries were induced. Group I (control) underwent only the abrasion procedure; Groups II and III received saline or bevacizumab intraperitoneally, respectively, following the abrasion. The rats were killed on postoperative day 7, and the severity of adhesions was evaluated, together with histopathological fibrosis parameters and immunohistochemical staining to identify the VEGF receptor. Results. The mean adhesion severity score in Groups I–III was 2.5 ± 0.52, 2.4 ± 0.69, and 0.7 ± 0.82, respectively; the score in Group III was significantly lower than that in Groups I (P < 0.001) and II (P < 0.001). In the histopathological evaluation, the mean fibrosis score in Group III was significantly lower that the scores in Groups I (P < 0.001) and II (P < 0.001). VEGF staining of the adhesion areas in Group III was significantly lower than that in Groups I (P < 0.001) and II (P < 0.001). Conclusion. Bevacizumab decreases adhesion formation following laparotomy in rats by blocking VEGF receptor occupancy

Hylan GF-20 and methyl-prednisolone’s effects on adhesion formation in rats underwent laparotomy

İstanbul Bilim Üniversitesi, Tıp Fakültesi.Amaç: Bu çalışmada Hylan GF-20 ve metil-prednizolonun laparotomi yapılan ratlarda yapışıklık oluşması üzerine etki gösterip göstermeyeceklerinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Kırk adet rat 4 gruba ayrılıp çekum ön duvarında 1 cm2'lik alanda steril gazlı bezle abrazyon oluşturuldu. Birinci gruptaki ratlara herhangi bir ilaç verilmez iken, 2. gruptakilere intraperitoneal 1 cc %4 Hylan GF-20 solüsyonu, 3. gruptakilere intraperitoneal 10 mg/kg metil prednizolon 4. gruptakilere intraperitoneal 1 cc %4 Hylan GF-20 solüsyonu + 10 mg/kg metil prednizolon verildi. Yedi gün sonra, grupları bilmeyen bir incelemeci tarafından daha önceki kesi hattı dışından tekrar laparotomi yapılarak kesi hattına ve çekuma olan yapışıklıklar değerlendirildi.Objective: In this study we aimed to investigate if Hylan GF-20 and methyl-prednisolone will effect upon the formation of adhesions in rats underwent laparotomy. Material and Method: Forty rats were divided into 4 groups and abrasion was created with sterile gauze at 1 cm2 area on the anterior wall of the cecum. In the first group, while the rats not given any drug, in the second group 1 cc of 4% solution of Hylan GF-20, in the third group 10 mg / kg methyl prednisolone and in the fourth group 1 cc %4 Hylan GF-20 solüsyonu +10 mg / kg methyl prednisolone 10 mg / kg methyl prednisolone were given intraperitoneally. Seven days later, adhesions with incision line and cecum were evaluated by an investigator blinded to group by doing again laparotomy outside earlier incision line

Fasciola Hepatica Case with Hemobilia

Fasciola hepatica (FH) can lead to important hepatobiliary diseases. Here we present a case of hemobilia associated with biliary FH, which is quite a rare case. The 41–year-old patient, who underwent common bile duct exploration due to hemobilia, was found to have arterial bleeding associated with ulcer caused by a dead parasite in the common bile duct. Hemobilia is a very rare complication associated with FH. When searching for the cause of hemobilia, FH should be considered

Effects of Copper, Zinc, and Vitamin Complex (Cernevit (R)) on Hepatic Healing in Rats Experimentally Subjected to Blunt Hepatic Trauma

WOS: 000371618600058PubMed ID: 27011508Solid organ injuries following blunt trauma are frequently encountered. The use of non-operative approach is gradually increasing. Thus, research on the methods that could enhance healing in solid organ injuries is in progress. Agents known to have antioxidant property were used after an experimentally induced blunt hepatic trauma. Thirty-two Wistar albino rats weighing 200 g were dropped from a height of 40 cm on to the right upper abdominal quadrant to produce a grade II-III hepatic injury. Rats were divided into control, Zn-administered, Cu-administered, and vitamin complex-administered groups, with eight rats in each. Aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) levels were measured in the blood samples. The percentage of cells displaying Ki-67 nuclear staining was estimated. The sections were stained with hematoxylin and eosin and the degree of inflammation in the samples was semi-quantitatively assessed. Treatment with zinc, copper, and Cernevit (R) caused varying levels of decrease in AST, ALT, and LDH levels compared to the control group. Ki-67 positivity was significantly lower in group I compared with groups II and III (p=0.002). Ki-67 positivity was significantly higher in group II compared to the other groups (p<0.05). A marked improvement was observed in inflammation in group II. Copper and zinc treatment decreased inflammation as well as blood levels of AST and ALT, and enhanced the healing of traumatized hepatic tissue. However, Cernevit (R) reduced only the degree of inflammation

Predictors of Postoperative Pancreatic Fistula (POPF) After Pancreaticoduodenectomy: Clinical Significance of the Mean Platelet Volume (MPV)/Platelet Count Ratio as a New Predictor

Purpose In this study, it was aimed to determine the predictors of clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreaticoduodenectomy (PD) and clinical significance of mean platelet volume (MPV)/total platelet count ratio (MPR) as a new predictor for CR-POPF